Engaging Young People who Inject Drugs into HCV and HIV Care

项目总结/摘要 背景：最近人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）爆发，包括 在印第安纳州，说明这些感染应同时处理，以改善结果。在 在美国，大多数新的丙型肝炎病毒感染是在年轻人谁注射毒品（PWID）。研究 在戒毒中心的研究表明，与护理的联系是有问题的。社会服务支持，如 管理有可能改善与护理的联系，但对其潜在影响知之甚少 照顾年轻的PWID。候选人：我是一名临床科学家，接受过联合内部 医学/儿科和传染病（ID）。我致力于研究改善健康的策略 向HCV和HIV感染者提供护理。在完成了哈佛贝丝以色列的ID奖学金后， 在Deaconess Medical Center，我加入了波士顿大学（BU）医学院，在那里我有 获得了与使用药物的患者一起工作的经验。我正在申请一个为期5年的K23奖，以获得 必要的技能和经验，成为一个独立资助的临床研究人员与专业知识， 设计、实施和分析临床干预措施。研究：我将使用ADAPT-ITT框架来修改 基于优势的病例管理（SBCM），与护理干预的循证联系，以解决 18至30岁的PWID需要在戒毒中心进行HCV和HIV检测。然后我将试点测试 适应性干预。具体目标是：（1）使用深入的定性访谈来确定促进者 和艾滋病毒和/或丙型肝炎护理中的联系和保留障碍;（2）利用目标1的发现， 改善护理中的联系和保留; 3）进行适应性干预的可行性研究， 为将来的审判做准备。培训：职业发展计划包括以下方面的培训： 干预措施，临床试验，先进的统计方法和物质使用研究。BU ID部门， 艾滋病研究中心（CFAR）和NIH资助的成瘾早期职业学习， 多样性计划提供了丰富的研究环境。导师：我的主要导师，Samet博士， 药物使用、艾滋病毒和丙型肝炎病毒方面的专门知识。Linas博士，我的共同导师，在HCV，HIV以及与 在乎顾问是伯恩斯坦博士（定性研究）、霍斯伯格博士（丙型肝炎病毒和艾滋病毒）和索伦森博士（物质 艾滋病毒）。在我的K23完成后，我将获得成为一个独立的人所需的技能。 一名临床研究者，专注于HCV和HIV与有物质史个体护理之间的联系 使用.

PROJECT SUMMARY / ABSTRACT Background: Recent human immunodeficiency virus (HIV) and hepatitis C virus (HCV) outbreaks, including the one in Indiana, illustrate that these infections should be addressed simultaneously to improve outcomes. In the United States most of the new HCV infections are among young people who inject drugs (PWID). Studies at detoxification centers have shown that linkage to care is problematic. Social services support such as case management has the potential to improve linkage to care; however, little is known about its potential influence on the care of young PWID. Candidate: I am a clinician scientist trained in combined internal medicine/pediatrics and infectious diseases (ID). I am committed to investigating strategies to improve health care delivery to HCV- and HIV-infected individuals. After completing an ID fellowship at Harvard's Beth Israel Deaconess Medical Center, I joined the faculty at Boston University (BU) School of Medicine, where I have gained experience working with substance using patients. I am applying for a 5-year K23 award to acquire the necessary skills and experience to become an independently funded clinician investigator with expertise to design, implement and analyze clinical interventions. Research: I will use the ADAPT-ITT framework to modify strengths-based case management (SBCM), an evidence-based linkage to care intervention, to address the needs of PWID aged 18 to 30 tested for HCV and HIV at a detoxification center. I will then pilot test the adapted intervention. The specific aims are to (1) To use in-depth, qualitative interviews to identify facilitators and barriers to linkage and retention in HIV and/or HCV care; (2) To use findings from Aim 1 to adapt SBCM to improve linkage and retention in care; 3) To conduct a feasibility study of the adapted intervention in preparation for a future trial. Training: The career development plan includes training in the development of interventions, clinical trials, advanced statistical methods, and substance use research. The BU ID department, the Centers for AIDS Research (CFAR) and the NIH-funded Learning for Early Careers in Addiction and Diversity program provide a rich research environment. Mentorship: My primary mentor, Dr. Samet, has expertise in substance use, HIV and HCV. Dr. Linas, my co-mentor, has expertise in HCV, HIV and linkage to care. Advisors are Drs. Bernstein (qualitative research), Horsburgh (HCV and HIV) and Sorensen (substance use and HIV). At the completion of my K23, I will have gained the skills necessary to become an independent clinician investigator focusing on HCV and HIV linkage to care among individuals with a history of substance use.